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department:Medicine. General Internal Medicine

recentyears:2

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An Impact-Oriented Approach to Epidemiological Modeling [Editorial]

Shah, Nirav R; Lai, Debbie; Wang, C Jason
PMCID:7505215
PMID: 32959348
ISSN: 1525-1497
CID: 4617602

Sustained Benefit of Alternate Behavioral Interventions to Improve Hypertension Control: A Randomized Clinical Trial

Rodriguez, Maria Antonia; Wang, Binhuan; Hyoung, Sangmin; Friedberg, Jennifer; Wylie-Rosett, Judith; Fang, Yixin; Allegrante, John P; Lipsitz, Stuart R; Natarajan, Sundar
[Figure: see text].
PMID: 33979183
ISSN: 1524-4563
CID: 4864532

Assessment of quantitative [18F]Sodium fluoride PET measures of knee subchondral bone perfusion and mineralization in osteoarthritic and healthy subjects

Watkins, L; MacKay, J; Haddock, B; Mazzoli, V; Uhlrich, S; Gold, G; Kogan, F
OBJECTIVE:F]NaF uptake in subchondral bone of individuals with and without knee osteoarthritis (OA). METHODS:) were evaluated using the Hawkins 3-compartment model. Measures were compared between structurally normal-appearing bone regions and those with structural findings. RESULTS:, and extraction fraction were significantly different between Healthy subjects and subjects with OA. Between-group differences in metabolic parameters were observed both in regions where the OA group had degenerative changes as well as in regions that appeared structurally normal. CONCLUSIONS:F]NaF PET imaging can complement assessments of structural abnormalities observed on MRI.
PMCID:8159876
PMID: 33639259
ISSN: 1522-9653
CID: 5579182

USPSTF recommends against screening adults in the general population for asymptomatic carotid artery stenosis

Tanner, Michael
SOURCE CITATION/UNASSIGNED:JAMA. 2021;325:476-81. 33528542.
PMID: 34058106
ISSN: 1539-3704
CID: 4924382

Linoleic acid (LA) and α-linolenic acid (ALA) inhibit conjugative transfer of an IncX4 plasmid carrying mcr-1

Li, Gong; Xia, Li-Juan; Zhou, Shi-Ying; Wang, Xi-Ran; Cui, Cao-Yue; He, Yu-Zhang; Diao, Xiao-Yuan; Liu, Ming; Lian, Xin-Lei; Kreiswirth, Barry N; Liu, Ya-Hong; Liao, Xiao-Ping; Chen, Liang; Sun, Jian
AIMS/OBJECTIVE:The aim at this study was to determine the effects of unsaturated fatty acids on clinical plasmids. METHODS AND RESULTS/RESULTS:, respectively, were used to assess the effects on conjugative transfer of a mcr-1-harboring plasmid pCSZ4 (IncX4) in conjugation experiment. The inhibitory mechanisms were analyzed by molecular docking and the gene expression of virB11 was quantitated by qRT-PCR. Target plasmid diversity was carried out by TrwD/VirB11 homology protein sequence prediction analysis. Our results showed that LA and ALA inhibit plasmid pCSZ4 transfer by binding to the amino acid residues (Phe124 and Thr125) of VirB11 with dose-dependent effects. The expression levels of virB11 gene were also significantly inhibited by LA and ALA treatment. Protein homology analysis revealed a wide distribution of TrwD/VirB11-like genes among over 37 classes of plasmids originated from both Gram-negative and Gram-positive bacteria, CONCLUSIONS: This study demonstrates representing a diversity of plasmids that may be potentially inhibited by unsaturated fatty acids. SIGNIFICANCE AND IMPACT OF STUDY/CONCLUSIONS:Our work reported here provides additional support for application of curbing the spread of multiple plasmids by unsaturated fatty acids.
PMID: 33034112
ISSN: 1365-2672
CID: 4627262

Defining Valid Activity Monitor Data: A Multimethod Analysis of Weight-Loss Intervention Participants' Barriers to Wear and First 100 Days of Physical Activity

Orstad, Stephanie L; Gerchow, Lauren; Patel, Nikhil R; Reddy, Meghana; Hernandez, Christina; Wilson, Dawn K; Jay, Melanie
Despite the popularity of commercially available wearable activity monitors (WAMs), there is a paucity of consistent methodology for analyzing large amounts of accelerometer data from these devices. This multimethod study aimed to inform appropriate Fitbit wear thresholds for physical activity (PA) outcomes assessment in a sample of 616 low-income, majority Latina patients with obesity enrolled in a behavioral weight-loss intervention. Secondly, this study aimed to understand intervention participants' barriers to Fitbit use. We applied a heart rate (HR) criterion (≥10 h/day) and a step count (SC) criterion (≥1000 steps/day) to 100 days of continuous activity monitor data. We examined the prevalence of valid wear and PA outcomes between analytic subgroups of participants who met the HR criterion, SC criterion, or both. We undertook qualitative analysis of research staff notes and participant interviews to explore barriers to valid Fitbit data collection. Overall, one in three participants did not meet the SC criterion for valid wear in Weeks 1 and 13; however, we found the SC criterion to be more inclusive of participants who did not use a smartphone than the HR criterion. Older age, higher body mass index (BMI), barriers to smartphone use, device storage issues, and negative emotional responses to WAM-based self-monitoring may predict higher proportions of invalid WAM data in weight-loss intervention research.
PMCID:9754231
PMID: 36530339
ISSN: 2227-9709
CID: 5387092

Carotid Doppler Measurement Variability in Functional Hemodynamic Monitoring: An Analysis of 17,822 Cardiac Cycles

Kenny, Jon-Émile S; Barjaktarevic, Igor; Mackenzie, David C; Elfarnawany, Mai; Math, Zhen Yang B; Eibl, Andrew M; Eibl, Joseph K; Kim, Chul Ho; Johnson, Bruce D
Carotid Doppler ultrasound is used as a measure of fluid responsiveness, however, assessing change with statistical confidence requires an adequate beat sample size. The coefficient of variation helps quantify the number of cardiac cycles needed to adequately detect change during functional hemodynamic monitoring.
PMCID:8202589
PMID: 34136821
ISSN: 2639-8028
CID: 4925602

Judging Medicine's Past: A Lesson in Professionalism

Lerner, Barron H
PMID: 34126029
ISSN: 1539-3704
CID: 4924632

Systems-Level Reforms to the US Resident Selection Process: A Scoping Review

Zastrow, Ryley K; Burk-Rafel, Jesse; London, Daniel A
Background/UNASSIGNED:Calls to reform the US resident selection process are growing, given increasing competition and inefficiencies of the current system. Though numerous reforms have been proposed, they have not been comprehensively cataloged. Objective/UNASSIGNED:This scoping review was conducted to characterize and categorize literature proposing systems-level reforms to the resident selection process. Methods/UNASSIGNED:Following Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, searches of Embase, MEDLINE, Scopus, and Web of Science databases were performed for references published from January 2005 to February 2020. Articles were included if they proposed reforms that were applicable or generalizable to all applicants, medical schools, or residency programs. An inductive approach to qualitative content analysis was used to generate codes and higher-order categories. Results/UNASSIGNED:Of 10 407 unique references screened, 116 met our inclusion criteria. Qualitative analysis generated 34 codes that were grouped into 14 categories according to the broad stages of resident selection: application submission, application review, interviews, and the Match. The most commonly proposed reforms were implementation of an application cap (n = 28), creation of a standardized program database (n = 21), utilization of standardized letters of evaluation (n = 20), and pre-interview screening (n = 13). Conclusions/UNASSIGNED:This scoping review collated and categorized proposed reforms to the resident selection process, developing a common language and framework to facilitate national conversations and change.
PMCID:8207920
PMID: 34178261
ISSN: 1949-8357
CID: 4964962

Qualitative analysis of medical student reflections on the implicit association test

Gonzalez, Cristina M; Noah, Yuliana S; Correa, Nereida; Archer-Dyer, Heather; Weingarten-Arams, Jacqueline; Sukhera, Javeed
INTRODUCTION:Health professions educators use the Implicit Association Test (IAT) to raise awareness of implicit bias in learners, often engendering strong emotional reactions. Once an emotional reaction ensues, the gap between learner reaction and strategy identification remains relatively underexplored. To better understand how learners may identify bias mitigation strategies, the authors explored perspectives of medical students during the clinical portion of their training to the experience of taking the IAT, and the resulting feedback. METHODS:Medical students in Bronx, NY, USA, participated in one 90-minute session on implicit bias. The focus of analysis for this study is the post-session narrative assignment inviting them to take the race-based IAT and describe both their reaction to and the implications of their IAT results on their future work as physicians. The authors analysed 180 randomly selected de-identified essays completed from 2013 to 2019 using an approach informed by constructivist grounded theory methodology. RESULTS:Medical students with clinical experience respond to the IAT through a continuum that includes their reactions to the IAT, acceptance of bias along with a struggle for strategy identification, and identification of a range of strategies to mitigate the impact of bias on clinical care. Results from the IAT invoked deep emotional reactions in students, and facilitated a questioning of previous assumptions, leading to paradigm shifts. An unexpected contrast to these deep and meaningful reflections was that students rarely chose to identify a strategy, and those that did provided strategies that were less nuanced. CONCLUSION:Despite accepting implicit bias in themselves and desiring to provide unbiased care, students struggled to identify bias mitigation strategies, a crucial prerequisite to skill development. Educators should endeavour to expand instruction to bridge the chasm between students' acceptance of bias and skill development in management of bias to improve the outcomes of their clinical encounters.
PMCID:8119345
PMID: 33544914
ISSN: 1365-2923
CID: 5294572